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pearl
1
Early initiation of norepinephrine infusion in septic shock is associated with decreased short-term mortality.
Li Y, Li H, Zhang D. Timing of norepinephrine initiation in patients with septic shock: a systematic review and meta-analysis. Crit Care. 2020 Aug 6; 24 (1): 488.
  Daniel Jolley
pearl
1
Perioperative β-blocker use should be tailored for patient and surgical risk factors, most importantly because of the association with increased mortality and stroke when their use is generalised.
Wang X, Fernandez C, Kertai MD. Perioperative β-blocker use: what is new in 2020? Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 417-422.
  Daniel Jolley
pearl
1
Pre-spinal-anaesthesia administration of IV ondansetron 4 mg reduces the ED50 of prophylactic phenylephrine infusion by 26% among patients undergoing elective Caesarean section.
Xiao F, Wei C, Chang X et al. A Prospective, Randomized, Double-Blinded Study of the Effect of Intravenous Ondansetron on the Effective Dose in 50% of Subjects of Prophylactic Phenylephrine Infusions for Preventing Spinal Anesthesia-Induced Hypotension During Cesarean Delivery. Anesth. Analg. 2020 Aug 1; 131 (2): 564-569.
  Daniel Jolley
pearl
1
High-inspired 80% FiO₂ shows no safety compromise when compared with standard 30-35% FiO₂ among surgical patients.
Mattishent K, Thavarajah M, Sinha A et al. Safety of 80% vs 30-35% fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta-analysis. Br J Anaesth. 2019 Mar 1; 122 (3): 311-324.
  Daniel Jolley
pearl
1
Left-lateral tilt has no effect on neonatal acid-base status when maternal blood pressure is maintained with crystalloid coload & phenylephrine infusion during elective cesarean delivery.
Lee AJ, Landau R, Mattingly JL et al. Left Lateral Table Tilt for Elective Cesarean Delivery under Spinal Anesthesia Has No Effect on Neonatal Acid-Base Status: A Randomized Controlled Trial. Anesthesiology. 2017 Aug 1; 127 (2): 241-249.
  Daniel Jolley
pearl
1
Phenylephrine & noradrenaline show similar incidence of bradycardia when used for postspinal hypotension prophylaxis during Caesarean section.
Mohta M, Garg A, Chilkoti GT et al. A randomised controlled trial of phenylephrine and noradrenaline boluses for treatment of postspinal hypotension during elective caesarean section. Anaesthesia. 2019 Jul 1; 74 (7): 850-855.
  Daniel Jolley
pearl
1
Preeclampsia diagnostic technologies continue to advance. Peripartum care is improved with multidisciplinary teams, specialist anaesthesia care and the availability of critical care support.
Russell R. Preeclampsia and the anaesthesiologist: current management. Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 305-310.
  Daniel Jolley
pearl
1
Closed-loop goal-directed fluid therapy with colloids is associated with lower volume infused and fewer postoperative complications than with crystalloids.
Joosten A, Delaporte A, Ickx B et al. Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery. Anesthesiology. 2018 Jan 1; 128 (1): 55-66.
  Daniel Jolley
pearl
1
Perineural dexamethasone prolongs interscalene block in a dose-dependent way between doses of 1 to 4 mg.
Albrecht E, Reynvoet M, Fournier N et al. Dose-response relationship of perineural dexamethasone for interscalene brachial plexus block: a randomised, controlled, triple-blind trial. Anaesthesia. 2019 Aug 1; 74 (8): 1001-1008.
  Daniel Jolley
pearl
1
Peri-operative hyperbaric oxygen therapy is associated with a range of outcome improvements, including various surgical-recovery and peri-operative indices.
Boet S, Martin L, Cheng-Boivin O et al. Can preventive hyperbaric oxygen therapy optimise surgical outcome?: A systematic review of randomised controlled trials. Eur J Anaesthesiol. 2020 Aug 1; 37 (8): 636-648.
  Daniel Jolley